109 articles - From Friday Oct 14 2022 to Friday Oct 21 2022
Guidelines, position statements, white papers, technical reviews, consensus statements, etc…
| Gut |
Green endoscopy: British Society of Gastroenterology (BSG), Joint Accreditation Group (JAG) and Centre for Sustainable Health (CSH) joint consensus on practical measures for environmental sustainability in endoscopy. In this consensus, we discuss practical measures to reduce the impact of endoscopy on the environment applicable to endoscopy units and practitioners. Adoption of these measures will facilitate and promote new practices and the evolution of a more sustainable specialty. |
meta-analyses and systematic reviews
| Endoscopy |
Clinical value of alarm features for colorectal cancer. A Meta-Analysis. When considered independently, alarm features have variable accuracy for CRC, given the high heterogeneity of study populations reflected by wide variability in CRC prevalence. Rectal bleeding and anemia are the most practical to select patients for colonoscopy. Integration of alarm features in a comprehensive evaluation of patient should be considered. |
| Gastrointest Endosc |
Occurrence of Gastric Cancer in Patients with Juvenile Polyposis Syndrome: A systematic review and meta-analysis. The value of GC surveillance in BMPR1A PGV carriers and JPS patients without an identifiable PGV is questionable. Germline testing should be performed in al JPS patients to inform GC risk discussion and utility of surveillance. |
RCT, clinical trials, retrospective studies, etc…
| Aliment Pharmacol Ther |
A prospective pilot study of a gluten-free diet for primary sclerosing cholangitis and associated colitis. However, a gluten/ATI-free diet may improve biomarkers of intestinal inflammation and barrier function in these patients with associated with changes in the enteric microbiota. Further investigation of the therapeutic potential of gluten-free diets in PSC-IBD is warranted. |
Assessing the clinical value of faecal bile acid profiling to predict recurrence in primary Clostridioides difficile infection. Gut BA metabolism dynamics differ in primary CDI patients between those developing recurrence and those who do not. Individual BAs show promise as potential novel biomarkers to predict CDI recurrence. |
Effect of risankizumab on health-related quality of life in patients with Crohn's disease: results from phase 3 MOTIVATE, ADVANCE and FORTIFY clinical trials. Risankizumab induction therapy (600 or 1200 |
Effect of time to pre-emptive transjugular intrahepatic portosystemic shunt on patient outcome, a UK multicentre cohort study. Placement of pTIPSS within 72 |
Impact of advanced practice providers on characteristics and quality of care of patients with chronic hepatitis B. Treatment-eligible patients with CHB receiving APP care were more likely to receive antiviral therapy. APP care may help to expand the pool of providers for patients with CHB, and to improve current suboptimal treatment rates. |
| Am J Gastroenterol |
Changes in lifestyle and risk of colorectal cancer in the European Prospective Investigation into Cancer and Nutrition. Improving adherence to a healthy lifestyle was inversely associated with CRC risk, while worsening adherence was positively associated with CRC risk. These results justify and support recommendations for healthy lifestyle changes and healthy lifestyle maintenance for CRC prevention. |
Characteristics and Impact of Anxiety and Depression Trajectories in Inflammatory Bowel Disease.: Anxiety and Depression Trajectories in IBD. In this 12-month follow-up study, patients with IBD with worsening or persistently high anxiety or depression scores were higher utilizers of healthcare but were not at increased risk of future adverse disease outcomes. |
Derivation and External Validation of Machine Learning-based Model for Detection of Pancreatic Cancer. Using widely available parameters in EHR, we developed and externally validated parsimonious machine learning-based models for detection of pancreatic cancer. These models may be suitable for real-time clinical application. |
Linaclotide Reduced Response Time for Irritable Bowel Syndrome with Constipation Symptoms: Analysis of Four Randomized Controlled Trials. Although treatment responses with linaclotide occurred in >50% of patients with IBS-C within 4 weeks of treatment initiation, benefits for individual abdominal symptoms and/or CSBM frequency can still occur between 4 and 12 weeks. A lack of improvement in one symptom does not negate the possibility of response for others, highlighting the importance of discussing al symptoms with patients and not assuming treatment futility at 4 weeks. |
| Clin Gastroenterol Hepatol |
Baseline characteristics and longitudinal outcomes of traditional serrated adenomas: a cohort study. Individuals with TSA have substantial risk for CRC, based on their cumulative CRC incidence, as well as significant risk of developing other high-risk neoplasia at follow up surveillance colonoscopy. These data underscore importance of current recommendations for close colonoscopy surveillance after TSA diagnosis. |
Food processing and risk of Crohn's disease and ulcerative colitis: A European Prospective Cohort Study. In the EPIC cohort, consumption of unprocessed/minimally processed foods was associated with a lower risk of CD. No association between UC risk and food processing was found. |
The sequential application of Baveno VII criteria and VITRO score improves diagnosis of clinically significant portal hypertension. The sequential application of VITRO in cACLD patients who were 'unclassifiable' in regard to CSPH by Baveno-VII-criteria substantially decreased the number of 'unclassifiable' patients to <15% and refined prognostication. |
| Endoscopy |
A Virtual Chromoendoscopy Artificial Intelligence system to detect endoscopic and histologic activity/remission and predict clinical outcomes in Ulcerative Colitis. Our system accurately distinguished ER/activity and predicted HR and clinical outcomes from colonoscopy videos. This is the first computer model developed to detect inflammation/healing using VCE through the PICaSSO score and the first computer tool providing endoscopic, histologic, and clinical assessment. |
Intermediate to long-term outcomes of endoscopic transpapillary gallbladder stenting in patients with gallstone-related disease: a 10-year single-center experience. Endoscopic transpapillary gallbladder stenting is an effective biliary drainage that should be considered in selected cases with common bile duct stone whose cholecystectomy could not be performed or deferred. Biliary event-free rate was 99% at 6 months and remained 92% at 1 year and 76% after 2-year follow-ups. |
Low risk of local recurrence after a successful en bloc Endoscopic Submucosal Dissection for non-invasive colorectal lesions with positive horizontal resection margins(R-ESD study). A positive horizontal resection margin after an en bloc ESD for non-invasive lesions is associated with a marginal non-significant increase of the local recurrence rate, equal to an ESD with clear horizontal margins. This could not be confirmed for T1 lesions. |
Motorized Spiral Enteroscopy-assisted ERCP in surgically altered anatomy: early experience from a retrospective cohort study. The current study showed for the first-time feasibility and safety of MSE-assisted ERCP in postsurgical patients with altered anatomy at an expert center. This data justifies further evaluation of this new technique preferably in a prospective multicenter trial. NCT04912440. |
| Gastroenterology |
Diversity, Equity, and Inclusion in Gastroenterology and Hepatology: A Survey of Where We Stand. Our survey explored imperative and timely perspectives on racial and ethnic representation and health equity among professionals in GI and hepatology. The findings should inform future interventions to address workforce diversity and establish priorities toward improving health equity, ultimately serving as a springboard for professional societies, academic institutions, and other organizations that aim to increase diversity, equity, and inclusion in our field. |
VONOPRAZAN VERSUS LANSOPRAZOLE FOR HEALING AND MAINTENANCE OF HEALING OF EROSIVE ESOPHAGITIS: A RANDOMIZED TRIAL. Vonoprazan was non-inferior and superior to the PPI lansoprazole in healing and maintenance of healing of erosive esophagitis. This benefit was seen predominantly in more severe erosive esophagitis. (ClinicalTrials.gov NCT04124926). |
| Gastrointest Endosc |
Clinical outcomes of endoscopic submucosal dissection for superficial circumferential esophageal squamous cell carcinoma. ESD is a highly curative treatment for cESCC with favorable long-term outcomes, especially in low-risk patients. Stricture-prevention techniques should be improved to optimize the benefits of ESD for cESCC. |
Development and validation of a machine learning-based model for varices screening in compensated cirrhosis (CHESS2001): An international multicenter study. We identified a novel model based on liver stiffness, platelet count, and total bilirubin, named ML EGD, as a free web-based calculator. ML EGD could efficiently help rule out HRV and avoid unnecessary EGDs in patients with compensated cirrhosis. |
Diversity, equity, and inclusion in gastroenterology and hepatology: a survey of where we stand. Our survey explored imperative and timely perspectives on racial and ethnic representation and health equity among professionals in GI and hepatology. The findings should inform future interventions to address workforce diversity and establish priorities toward improving health equity, ultimately serving as a springboard for professional societies, academic institutions, and other organizations that aim to increase diversity, equity, and inclusion in our field. |
Factors predictive of persistent fistulas in EUS-Directed transgastric ERCP: A multicenter matched case-control study. Longer LAMS dwell time was found to be associated with a higher risk of persistent fistulas in EDGE patients. APC or primary closure of the fistula on LAMS removal was not found to be protective against developing a persistent fistula, which if present, can be effectively managed through endoscopic closure in most cases. |
Motorized Spiral Enteroscopy versus Double Balloon Enteroscopy: A Case-Matched Study. In patients requiring enteroscopy, the diagnostic and therapeutic performance of MSE is similar to DBE. An increased frequency of adverse events was observed with MSE. There are some restriction in the indication because of the design of MSE. |
Next generation sequencing mutation analysis on biliary brush cytology for differentiation of benign and malignant strictures in primary sclerosing cholangitis. NGS mutation analysis of PSC brush cytology detects oncogenic mutations with high sensitivity and specificity and seems to constitute a valuable adjunct to cytological assessment of brush samples. |
Outpatient flexible endoscopic diverticulotomy for the management of Zenker's diverticulum: a retrospective analysis of a large single center cohort. All significant adverse events requiring endoscopic or surgical intervention were identified prior to discharge. Delayed adverse events occurred in 2.5% of cases, al of which were managed supportively. Our data are comparable to published cohorts of admitted patients, demonstrating that appropriately selected patients may be managed as outpatients while maintaining similar safety outcomes. |
Telecytology versus in-room Cytopathologist for Endoscopic Ultrasound Fine Needle Aspiration or Biopsy of Solid Pancreatic Lesions. Rapid on-site evaluation using Telecytology was not associated with any difference in final histologic diagnosis for EUS-FNAB of solid pancreatic masses. This has important implications for optimizing clinical workflows. |
Usefulness of a novel computer-aided detection system for colorectal neoplasia: A randomized controlled trial. Colonoscopy assisted by ENDO-AID (OIP-1) increases ADR and APC, suggesting that it may prevent the overlooking of colorectal neoplastic lesions, especially because of its detection of diminutive and flat adenomas. |
| Gut |
Effect of endoscopic sleeve gastroplasty on gastric emptying, motility and hormones: a comparative prospective study. ESG promotes weight loss through several key mechanistic pathways involving GE and hormones while preserving GM. These findings further support clinical adoption of this technique for the management of obesity. |
Identification of bacterial lipopeptides as key players in IBS. PS impacts the gut microbiota composition and metabolic function in adulthood. The reduced capacity of the gut microbiota to produce GABA lipopeptides could be one of the mechanisms linking PS and visceral hypersensitivity in adulthood. |
Population-based investigation of common and deviating patterns of gastric cancer and oesophageal cancer incidence across populations and time. Correlations between GC and EC incidence rates across populations are positive or inverse depending on the GC subsite and EC subtype. Multisite studies that include a combination of populations whose incidence rates follow and deviate from these patterns may be aetiologically informative. |
| J Hepatol |
Hereditary cancer variants and homologous recombination deficiency in biliary tract cancer. This study described the heritability and the actionability of homologous recombination deficiency targeted treatments and provides possibilities for expanding therapeutic strategies and screening for BTCs. |
| J Neurogastroenterol Motil |
Association Between the Cool Temperature-dependent Suppression of Colonic Peristalsis and Transient Receptor Potential Melastatin 8 Activation in Both a Randomized Clinical Trial and an Animal Model. For the first time, this study demonstrates that cool temperature-dependent suppression of colonic peristalsis may be associated with TRPM8 activation. |
Clinical Implications of the Gastroesophageal Reflux Disease Questionnaire and Reflux Symptom Index in Patients With Suspected Laryngopharyngeal Reflux Symptoms. In patients with LPR symptoms, significant discrepancies are observed between laryngoscopic diagnosis and GERD. In this population, neither GerdQ nor RSI is useful in diagnosing GERD. |
Compositional Changes in the Gut Microbiota of Responders and Non-responders to Probiotic Treatment Among Patients With Diarrhea-predominant Irritable Bowel Syndrome: A Post Hoc Analysis of a Randomized Clinical Trial. Background/aims We aim to evaluate the differences in the microbiome of responders and non-responders, as well as predict the response to probiotic therapy, based on fecal microbiome data in patients with diarrhea-predominant irritable bowel syndrome (IBS-D). Methods A multi-strain probiotics that contains is correlated to symptom improvement by probiotics in patients with IBS-D. |
Distribution and Function of Platelet-derived Growth Factor Receptor Alpha-positive Cells and Purinergic Neurotransmission in the Human Colon: Is It Different Between the Right and Left Colon? Purines reduce right and left colon contractility similarly, and purinergic inhibitory neurotransmission can be regulated by PDGFRa + cells in the human colon. |
Estimating Probability for Esophageal Obstruction: A Diagnostic Decision Support Tool Applying Machine Learning to Functional Lumen Imaging Probe Panometry. Application of FLIP metrics utilizing a probabilistic approach incorporates the diagnostic confidence (or uncertainty) into the clinical interpretation of EGJ obstruction. This tool can provide clinical decision support during application of FLIP Panometry for evaluation of esophageal motility disorders. |
Infantile Colic and the Subsequent Development of the Irritable Bowel Syndrome. Children with a diagnosis of infantile colic during the infant period had a significant risk of developing IBS after 4 years of age. Understanding the pathogenesis of infantile colic in the neonatal period may reduce the prevalence and severity of functional gastrointestinal disorders from childhood to adolescence to adulthood. |
Mean Nocturnal Baseline Impedance and Post-reflux Swallow-induced Peristaltic Wave Index Could Identify Gastroesophageal Reflux Disease but pH-Impedance Metrics Alone Might Not Correlate With Proton Pump Inhibitor Response in Chinese Patients With Typical Reflux Symptoms. It is reasonable to set 4% as a threshold to define pathological AET in Chinese patients. MNBI and PSPWi could identify GERD patients, but may not correlate with PPI response of Chinese GERD patients. |
Predicting Responsiveness to Biofeedback Therapy Using High-resolution Anorectal Manometry With Integrated Pressurized Volume. Integrated pressurized volume parameters were better than conventional parameters in predicting the responsiveness to biofeedback therapy, and the combination of these parameters and partial least squares regression was particularly promising. Integrated pressurized volume parameters can more effectively explain the physiology of the anorectal canal compared with conventional parameters. |
Relationship Between Intestinal Slow-waves, Spike-bursts, and Motility, as Defined Through High-resolution Electrical and Video Mapping. Motility patterns were dictated by patterns of spike-burst patches. When spike-bursts were coupled to slow-waves, periodic motility patterns were observed, while when spike-bursts were not coupled to slow-waves, spontaneous aperiodic motility patterns were captured. |
Subtype of Achalasia and Integrated Relaxation Pressure Measured Using the Starlet High-resolution Manometry System: A Multicenter Study in Japan. We should cautiously interpret the type of achalasia and IRP values in the Starlet HRM system. Symptoms of recurrent cases are related to disease progression rather than IRP values, which should be considered in decision making. |
The Conundrum of Obesity and Gastroparesis Hospitalizations: A Retrospective Comparative Analysis of Hospitalization Characteristics and Disparities Amongst Socioeconomic and Racial Backgrounds in the United States. In the US, compared to non-obese, a higher proportion of obese GP hospitalizations were female and Blacks. Obese GP hospitalizations also had higher THC, LOS, and rates of upper endoscopy. |
Transient Hiatal Separation During Straight Leg Raise Can Predict Reflux Burden in Gastroesophageal Reflux Disease Patients With Ineffective Esophageal Motility. Our work suggests that SLR may have value as a provocative test during HRM, and future outcome studies are warranted to elucidate the clinical relevance of motor abnormalities depicted from SLR. |
Type of Rectal Barostat Protocol Affects Classification of Hypersensitivity and Prediction of Symptom Severity in Irritable Bowel Syndrome. Our study indicates that a rectal barostat protocol using phasic isobaric distensions with stepwise pressure increments is more sensitive in IBS patients with respect to identifying subjects with rectal hypersensitivity and a link with IBS symptoms. |
| Neurogastroenterol Motil |
Chronic jetlag reprograms gene expression in the colonic smooth muscle layer inducing diurnal rhythmicity in the effect of bile acids on colonic contractility. Chronodisruption abolished the rhythm in bile acid levels which might contribute to a shift in smooth muscle clock gene expression. Our findings suggest that chronodisruption caused a transcriptional reprogramming in the colonic smooth layer thereby inducing a rhythm in the expression of Gpbar1 and in the inhibitory effect of TDCA on colonic contractility. |
Clinical efficacy and mechanism of transcutaneous neuromodulation on ineffective esophageal motility in patients with gastroesophageal reflux disease. IEM is an important link in the pathogenesis of GERD. Chronic TN treatment can significantly improve the clinical symptoms of patients. Acute TN treatment can significantly increase LES pressure and DCI and reduce the frequency of esophageal lost peristalsis and weak peristalsis. The improvement of esophageal motility in GERD patients with IEM by TN treatment may be related to the regulation of autonomic nervous function. |
Heterozygous Actg2R257C mice mimic the phenotype of megacystis microcolon intestinal hypoperistalsis syndrome. A mouse model demonstrating MMIHS-like symptoms was generated. The Actg2 R257C heterozygous variant impairs SMCs contraction by interfering with actin polymerization, leading to GI motility disorders. |
Long-lasting visceral hypersensitivity in a model of DSS-induced colitis in rats. DSS-induced colitis in rats is associated to the generation of a long-lasting state of visceral (colonic) hypersensitivity, despite clinical colitis resolution. This model reproduces the changes in intestinal sensitivity characteristics of inflammatory and functional gastrointestinal disorders in humans and can be used in the characterization of new pharmacological treatments against visceral pain. |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Gastroenterology |
Current Best Practice in Hepatitis B Management & Understanding Long-Term Prospects for Cure. Major advancements in our understanding of HBV virology along with better understanding of immunopathogenesis have led to the development of a multitude of novel therapeutic approaches with the prospect of achieving functional cure (HBsAg loss) and perhaps complete cure (clearance of cccDNA and integrated HBV DNA). This review will cover current best practice for managing chronic HBV infection and emerging novel therapies for HBV infection and their prospect for cure. |
| Gastrointest Endosc |
Variability in Adenoma Detection Rate in Control Groups of Randomized Colonoscopy Trials. A high level of variability was found in the level of ADR in the controls of RCTs. With regards to indications, only FIT-based colonoscopy studies influenced basic ADR, primary colonoscopy screening appeared to be similar to other indications. Standardization for variables related to clinical, methodological, and technical parameters is required to achieve generalizability and reproducibility. |
| J Neurogastroenterol Motil |
Concise Review: Applicability of High-resolution Manometry in Gastroesophageal Reflux Disease. The recent international guidelines have positioned high-resolution manometry as an important part of functional diagnostic work up in GERD in order to identify the GERD phenotype to guide specific treatment. The proposed manometric identification and measurement is based on the Chicago classification version 4.0 adding with new established metrics for GERD evaluation. |
Inflammation and Impaired Gut Physiology in Post-operative Ileus: Mechanisms and the Treatment Options. This review discusses potential mechanisms and factors involved in the pathophysiology of POI with special reference to inflammation and interlinked events such as epithelial barrier dysfunction and dysbiosis. Based on this review, we recommend CRF, mast cells, macrophages, and microbiota could be targeted concurrently for efficient POI management. |
The Role of Short Chain Fatty Acids in Irritable Bowel Syndrome. We discuss the underlying mechanisms of action of SCFAs in intestinal inflammation and immunity, intestinal barrier integrity, motility, and the microbiota-gut-brain axis. Limited to previous studies, further studies are required to investigate the mechanisms of action of SCFAs in IBS and provide more precise therapeutic strategies for IBS. |
misc publications eg case reports, tools of the trade, images of the month, etc…
| Am J Gastroenterol |
| Clin Gastroenterol Hepatol |
| Endoscopy |
| Gastroenterology |
| Gastrointest Endosc |
| Gut |
| Hepatology |
| J Hepatol |
Letters to the editors and authors’ replies
| Clin Gastroenterol Hepatol |
| Gut |
| Hepatology |
| J Hepatol |
| J Neurogastroenterol Motil |